Agenda and minutes

None.

None.

It was noted that the Committee’s request for further information was circulated to Members on 9 November 2021

RESOLVED: That the minutes from the meeting on 26 October 2021 be approved as an accurate record.

It was confirmed that there were no Part II items and that all business would therefore be conducted in public.

The Consultant in Public Health/Deputy Director of Public Health introduced the report on the Public Health Integrated Services Contracts.

An update was provided on the following commissioned Public Health contracts:

·         NHS Health Checks

·         Adult and Children’s Weight Management Services

·         Integrated Sexual and Reproductive Health Services

·         Integrated Specialist Community Substance Misuse Services

·         Smoking Cessation Services

·         Healthy Start Scheme

The Committee was updated on the cost of the different services and how they had developed over the years. It was reported that services had been tailored to meet the needs of residents and this was continuously reviewed in light of changing circumstances. Since 2013, some services such as Integrated Sexual and Reproductive Health (ISRH) Services and Integrated Specialist Community Substance Misuse Services which each had been made up originally of a range of service providers had, following going out to tender, been transformed into a prime provider delivery model in order to provide more integrated services for residents and  increased efficiency.

It was noted that services were always being developed to meet changing demands.  The example of mystery shopping exercises, which were conducted periodically to identify possible gaps in provision and to provide service user feedback regarding  aspects of the commissioned that could be improved.  There was also an increased focus on raising the profile of the different services available to residents. This was evident in for example the Healthy Start Scheme where raising the profile and awareness of the service among care and health professionals had led to an increase in uptake of the service from residents.

In terms of baseline information about performance, the Committee noted that it would welcome pre-COVID-19 data as well as comparison of performance against our statistical neighbours in future reporting.  It was felt that this would provide a clearer understanding of the performance of services. 

The cost pressures around NHS Health Checks were acknowledged however the Committee raised concerns about the 13.3% of the eligible population that was not being reached. Although this figure may have improved it was difficult to compare this figure in the absence of comparative data.  It was noted that although the pandemic had impacted the number of health checks undertaken, this was gradually beginning to improve.

It was noted that preventative work was being done with GPs to raise the profiles of the different services (ie. the Emerald Pathway, the Healthy Start Scheme, Smoking Cessation Services, Adult Weight Management) available to residents. The services offered residents support to avoid health issues such as heart disease and strokes.

The Committee considered that equity of provision was important and stated that it would welcome maps of areas showing deprivation in future reporting and how this is used to inform the future planning of services. It was confirmed that many of the figures in the report were obtained from The Public Health Outcomes Framework (PHOF).  It was noted that the PHOF is updated every quarter, however, due to COVID-19 some of the indicators had not been updated since 2019. PHOF reported  performance  ...  view the full minutes text for item 51.

The Corporate Director for Planning, Environment, Education and Community Services and the School Place Planning Project Manager introduced the report and provided an overview of the latest quarterly update on school places.

It was reported that since August 2021, the Council had experienced unprecedented levels of new applications for school places in all year groups. Some schools had begun consulting on reducing the Published Admissions Number (PAN) to take effect from 2023, however this was subject to parental demand. After the consultation responses had been analysed, a report would be presented to the Committee in January 2022 and then to Cabinet to decide if the proposals should go ahead.  

It was noted that the results from the October consensus were still outstanding. A more detailed report would be presented in Spring 2022 as the information would all be available then. A significant change noted since the last update was the unprecedent number of late applications (at least 100) in every year group. There were several planning and feasibility projects underway and more expansion in Special Educational Needs (SEN).

In response to Member questions about new applications and how this impacted the SEN provision and children with Education Healthcare Plans, it was reported that procedures had been established. Some children started in mainstream schools and undertook assessments at a later stage, adding to the demand for SEN places. The figures on this were requested at the next meeting.

Information on primary, secondary and SEN places and safety valves was requested in future reporting. There should be at least a 5% margin in schools, and it was questioned whether this was being worked towards in secondary schools. It was confirmed that the application deadline for secondary places was on 31 October 2021 and work was being done towards national offer day. Although the projections had been made, the process involved a number of stages including sharing information with boroughs before figures and places were settled and the demand could accurately be confirmed.

In relation to the cumulative effect of PAN reductions, it was confirmed that officers were confident of the cumulative effect and the overall picture had been considered. The changes would be a more efficient way of working as overstaffing schools could increase financial deficit. Plans had been developed in partnership and close liaison with schools.

In terms of the need for a new school in the north of the Borough, it was noted that this would become clearer when the results from the October census had been obtained. A crucial factor indicating that a new secondary school may be needed was the number of primary school applications.

Questions were raised regarding Hillside Infants school proposed PAN reduction when it had just recently developed its buildings. It was explained that Hillside Infants school was located at the far north of the Borough and the increased demand for places had been mainly from out-borough. This demand had now changed following Brexit and it was therefore sensible to review the school’s operating figures.  ...  view the full minutes text for item 52.

The Head of Business Delivery & Support presented the results of the recent Assisted Living Technology (ALT) survey, provided an overview of case studies, summarised social care staff feedback and links to wider strategy development, such as Telecare and digitisation.

It was reported that the ALT survey was sent to residents, including people in receipt of the TeleCareLine service, people living within Extra Care, Supported Living, Sheltered Housing and Residential Care units, service users, parents and carers in receipt of Direct Payments. This included children, young people, adults and older people using a variety of services including supported living for people with learning disabilities, for those using mental health services and people with physical disabilities and extra care needs.

101 survey responses were received, and it was noted that a wide range of ALT was already in place. There was generally satisfaction with the equipment and reasons for not liking or using products were around not liking or using it or forgetting to wear it. 54% of survey respondents had used the equipment in an emergency and the outcomes were positive. The number of people wanting more equipment or technology to help them remain safe and independent at home was 21%. Some of the main types of equipment or technology that people wanted were Alexa or Echo device. Reasons for why people did not want more equipment were in relation to people not wanting to pay.

The Committee heard about different case studies from residents in The London Borough of Hammersmith & Fulham who had used ALT technology. Stockton on Tees council also used ALT to enable people to remain at home and live independently whilst avoiding high cost residential care home placements. Other case studies were from The London Borough of Lewisham and Cardiff Council.

Members were provided with feedback from Hillingdon staff and residents. It was reported that digitalisation was being considered as a wider project across the Council and how it affected each service area, not just within social care. A strategy was to be developed and a final strategy would be in place by 31 March 2022 covering a 3-5year period. 

During Member questions, it was noted that the survey would have been helpful at the start of the review to help inform the questions asked to witnesses. 101 responses to the surveys were generally good but there was disappointment in the number of under the age of 40 responses. It was explained that although the survey respondent may not have been under 40, the survey could have been completed by a parent or carer on their behalf. The survey was sent to a range of social care service users not just those in direct care of Telecare. Information on the timeline of the survey would be provided.

Members considered that the survey was good and insightful and noted that carer and client needs were different. The Committee was pleased to see the geographical spread. There was disappointment that Brunel University had no live research but Members thanked  ...  view the full minutes text for item 53.

 The Committee discussed the findings of the review and identified these themes:

•             That the outputs of the contributions from service users, families and carers, health and voluntary sector partners, care providers, manufacturers and local authorities are reflected in the forthcoming Assistive Living Technology (ALT) Strategy as part of the wider LBH digitisation programme. The strategy would consider all the major entry points that residents have with the Council whether that be universal services or social care.

•             Develop a checklist to support the social care assessment process to ensure that the potential of the current and prospective future ALT offer is fully harnessed as part of any assessed support package. This is with a view to stress that this is not necessarily to replace human contact but to augment the totality of the offer and its capacity to support independent living and help achieve improved outcomes with social care needs and or/long term health conditions. This may be similar to the Patient Activation Measure employed by Hillingdon for All.

•             Explore the development of a narrative with support to tackle myths about ALT and engender confidence in its usage on the part of service users and families. 

•             Work to ensure that providers take a consistent approach in moving all their systems online to improve the effectiveness of service monitoring and delivery in sync' with health and social care partners. Use data elicited from the existing and developing ALT offer to improve synergies with information on for example slips and falls to inform appropriate revisions to health and social care support packages.

•             Conduct a training needs analysis to support the rollout of headset training and other appropriate training interventions to gain the maximum benefit to the extension of the ALT offer. 

•             Continue to liaise with Brunel University and other sources of research and development to ensure the ongoing evolution of the ALT strategy continues to be informed by emerging good practice.   

•             Continuously listen to service users as an informal way of consulting, not just during reviews.  Ensure that lines of enquiries are conducted regularly rather than on a one off basis.

•             Clearly identify how barriers for take up for technology would be managed as Members had heard during the review that many people did not have access to internet.

•             Formulate an action plan to show targeted outcomes, timelines and what success what would look like.

•             Consider any fees attached to equipment as many survey users said that costs where a factor in choosing products.

RESOLVED: That the Committee discussed the findings of its review of Assisted Living Technologies in Hillingdon and considered early draft recommendations in relation to the review.

The Committee agreed to add a Public Health Update on Integrated Service in March/April 2022 and to the amend work programme to receive the minutes from the Corporate Parenting Panel in February 2022. The Committee requested an update on Covid and this was being managed.

RESOLVED: That:

1)    a Public Health Update on Integrated Service be added to the work programmed in March/April 2022;

2)    the Corporate Parenting Panel minutes to go to the Committee in February 2022; and

3)    Democratic Services to liaise with officers to arrange a Covid update.

RESOLVED: That the forward plan be noted.